2 Learning Outcomes47.1 Describe the characteristics of urine, including its formation, physical composition, and chemical properties.47.2 Explain how to instruct patients in specimen collection.47.3 Identify guidelines to follow when collecting urine specimens.47.4 Describe proper procedures for collecting various urine specimens.

3 Learning Outcomes (cont.)47.5 Explain the process of urinary catheterization.47.6 List special considerations that may require you to alter guidelines when collecting urine specimens.47.7 Explain how to maintain the chain of custody when processing urine specimens.47.8 Explain how to preserve and store urine specimens.

4 Learning Outcomes (cont.)47.9 Describe the process of urinalysis and its purpose.47.10 Identify the physical characteristics present in normal urine specimens.47.11 Identify the chemicals that may be found in urine specimens.47.12 Identify the elements categorized and counted as a result of microscopic examination of urine specimens.

5 Introduction Routine analysis of a urine specimen Medical assistantNoninvasiveUsed to diagnose significant conditionsMedical assistantLearn about types of urine specimensInstruct or assist patient in collection of a sampleLearn to process urine specimensLearn about normal / abnormal components of urine

6 Role of the Medical AssistantCollect, process, and test urine samplesKnowledge necessaryAnatomy and physiology of kidneysHow urine is formedNormal components of urine

7 Role of the Medical AssistantSafetyStandard PrecautionsPPE as neededHandle and dispose of specimens properlyDispose of used supplies and equipment properlySanitize, disinfect, and/or sterilize reusable equipment

9 Anatomy and Physiology of the Urinary System: Formation of UrineNephronFunctional unit of the kidneyRemoves end products of metabolismAllows for reabsorption of water and electrolytesMaintains normal fluid balanceProcesses in urine formationGlomerular filtrationTubular reabsorptionTubular secretion

11 Apply Your Knowledge Very Good!What knowledge is needed by the medical assistant related to collecting, processing, and testing urine specimens?ANSWER: The medical assistant needs to know the anatomy and physiology of the urinary system, how urine is formed, and normal components of urine.Components of normal urine includeA. urea, uric acid, and ammonia.B. chloride, potassium, and sugar.C. red blood cells, sperm, and H2O2D. hydrogen ions, urochrome, and uranium.ANSWER:Very Good!

12 Obtaining Specimens General collection guidelinesFollow the procedure for specified testUse an appropriate specimen containerLabel the specimen container correctlyExplain the procedure to patientWash your hands before and after the procedure; wear gloves during the procedureComplete all necessary paperwork

13 Obtaining Specimens: TypesQuantitative analysis – measures amount of a specific substance in the urineQualitative analysis – simply determines if a substance is present in the urineTypes vary in the method used to collect a specimen and in the time frame in which to collect a specimen

14 Obtaining Specimens: Types (cont.)Random urine specimenMost commonObtained any time during the dayFirst morning specimenContains greater concentration of substancesClean-catch midstreamUsed for culturing urineExternal genitalia must be cleansedDiscard small amount of urine prior to collecting specimenCan also obtain by catheterization

15 Obtaining Specimens: Types (cont.)Timed urine specimenDiscard first specimenCollect all urine for specified timeRefrigerate24-hour specimenCollected as a timed specimenBoth are used for qualitative and quantitative analysis

23 Obtaining Specimens: Preservation and StorageChemical, physical, and microscopic changes occur if urine is left at room temperature for more than 1 hourPreservationRefrigerationPrevents growth for 24 hoursReturn to room temperature before testingChemical preservativesSpecimens only

24 Correct! Apply Your KnowledgeA patient has returned to the office and is complaining of not being able to empty her bladder fully after her hysterectomy. The physician has asked you measure the patient’s residual urine. How do you do this and why?ANSWER: A residual urine is done to measure the amount of urine in the bladder after voiding. You will ask the patient to empty her bladder and then perform a straight catheterization to measure any urine remaining in her bladder.Correct!

25 UrinalysisEvaluation of urine to obtain information about body health and diseaseTypes of testingPhysicalChemicalMicroscopic

42 Apply Your Knowledge Super!A urinalysis has detected that a patient has protein in his urine. Why is this important?ANSWER: Protein in the urine usually indicates renal disease.Super!

43 In SummaryCharacteristics of urine provide information about a patient’s healthMedical assistantCollects, processes, and tests urine specimensMust understand the urinary system and characteristics of urineAssists and instructs patients in specimen collection

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